Tuesday, March 8, 2011

Kobayashi Maru In Colorado

Are you familiar with the Kobayashi Maru?

According to my good friend, Dr. Wik E. Pedia, the Kobayashi Maru is a test in the fictional universe of Star Trek. It is a Starfleet training exercise designed to test the character of cadets in the command track at Starfleet Academy. The test's name is occasionally used among Star Trek fans or those familiar with the series to describe a no-win scenario.

James T. Kirk took the test three times while at Starfleet Academy. Prior to his third attempt, Kirk surreptitiously reprogrammed the simulator so that it was possible to beat the test. Here’s how that looked in the 2009 movie:

So why I am sharing this with you, other than to expose my inner nerd?

Because I believe that right here in Colorado we are facing a Kobayashi Maru in the way we fund and provide services for individuals with one or more developmental disabilities.

Over the past six years, with the transition from a quasi-managed care system to a fee-for-service system, the DD world in Colorado has become mired in an unsustainable mechanism of paying for and delivering services, which has resulted in fewer services being delivered at a lower level of quality.

Service providers now deliver services more to meet the needs of a myriad of rules and regulations rather than to meet the needs of the individuals they serve. Services are now reduced to merely meeting the health and safety needs of those we serve.

Now, I want to make it clear that I of course understand that the health and safety of those we serve is paramount. But I believe that is where services should start, not end.

The end point should be community inclusion – individuals with intellectual disabilities becoming contributing members of their communities. One of the core beliefs we hold at Imagine! is that success that is limited to a classroom or controlled, segregated environment is a very incomplete success. We strive to go beyond those limitations and broaden our horizons, as well as the horizons of the people we serve.

Now the primary funder of services for those with cognitive disabilities might respond to those lofty goals by saying, “That’s not what we are paying you for.” To which I would respond, a) “Considering that service providers in Colorado are paid an average of 80 cents for every dollar’s worth of service delivered, and providers accept this as payment in full, the intent of the service cannot be achieved,” and b) “That is exactly the problem – we have created a Kobayashi Maru where nobody wins – not the taxpayer, not the service provider, and certainly not the individual receiving services.”

Now, I don’t want to compare myself to Captain Kirk. I’ve never battled a Gorn, had troubles with tribbles, or bedded a green skinned alien.

However, I do have a solution to beating the Kobayashi Maru we face in the DD system in Colorado. I’ve even seen it work.

You may know that I spent a good deal of my career working in Imagine!’s Labor Source department during a time when rules were more flexible. Those years were some of the most important in my life in terms of cementing my belief that providing services to individuals with developmental disabilities is a community responsibility. A former colleague of mine said it best when he described Labor Source’s responsibility back then as facilitating the meeting of mutual obligation between consumers and community.

Our job wasn’t to “do” the work of providing community opportunities and interaction, our job was to make sure it got done. A subtle distinction, perhaps, but a profoundly vital one. Under that philosophy, providers, consumers, and community members were all equal partners in a mutually beneficial system.

And guess what? It worked. And it was cost effective. And it was sustainable. It is still the intent to this day, despite the many constraints that Labor Source must endure because of the way they currently receive their funding.

When we first developed that philosophy back then, we didn’t accept that our job was simply to protect the health and safety of those we served. We knew that if we just used that as our measure of success, the result would be poor services delivered in a segregated setting. Instead, we had a vision of something much bigger and made it happen. We beat the Kobayashi Maru by reprogramming the intent of our services.

There is no reason the Kobayashi Maru can’t be beat across the state of Colorado, for all that need services. We just need to reprogram our thinking, and our funding system.

Then again, what do I know?


  1. Those were the days my friend, we thought they would never end! We accomplished so much, but it appears to have been for not... so sad!

  2. Well said Mark.
    It is a community responsibility.
    Let's empower those who the services are
    intended to serve.

  3. Hey Mark,

    Are there a lot of limits to what volunteer programs can accomplish? That seems the immediate solution for some of our issues at least...

  4. Thanks for the comments folks. Bruce, I agree. Volunteer programs,faith-based organizations, and more collaboration are all solutions worthy of exploration.

  5. "Then again, what do I know?" is a pretty good caveat and mindset, and we'd all be better off if more of those who stubbornly think they know what they're talking about took that caveat to heart. But this I do know. My 4 years at Labor Source (17 years ago, Christ how the time flies), were at least as educational and formative as the four years I spent in college. My sense of the meaning of community, personal obligation, of difference and toleration, the dignity that comes from work, and the moral power of integration, all have been powerfully shaped by my time there. It was supposed to be me teaching consumers, but in the end I learned as much if not more both from my service to them, but also from them directly. And I think that is at least part of what Mark is talking about when he says there's potential in 'reprogramming thinking'. Human services, done well, benefit everyone - not just those who are supposedly the primary beneficiaries (i.e. the consumers), but, and I mean this quite literally, everyone benefits. The challenge is recognizing, measuring and communicating these benefits. (It's hard to recognize benefits when you're struggling with someone on a sidewalk somewhere, but just step back a bit and the reality of this is glaringly obvious.) Many people in today's society don't like to admit that they benefit from the public good. Flies in the face of our myths of individualism, and raises the notion that we owe something to the efforts of managing the public good. But this point - that we all benefit from good human service - must be championed. Since Mark contacted me a few weeks ago, I've had the chance to review Imagine!'s webpages, and I've been thoroughly impressed, though not surprised, by the examples of the creative professionalism I've seen there. Keep up the good work, I know you'll keep asking the caveat.

  6. The promotion of volunteerism seems fully consistent with a philosophy of facilitating mutual obligations of consumers and communities. Of course, it seems important to me that volunteerism be conceived and treated as a complement to professional services rather than a substitute for them. To the extent that volunteerism is a budget strategy, I think we should be skeptical. I do think it is fair (and possibly desirable) to expect professional service providers to evolve the nature of their service as communities become more willing participants in the lives of persons with disabilities. In other words, facilitating volunteerism, monitoring it, assessing its efficacy and so on might take on a greater share of service providers' professional responsibilities.
    - JM